Evaluating comprehensive cancer networks; a review of standards and evaluation methods for care networks to inform a comparison with the OECI comprehensive cancer network standards

To ensure that all citizens have equal access to high-quality cancer diagnosis and care, the EU4Health Programme, Europe’s Beating Cancer Plan, and Horizon Europe’s Cancer Mission propose Comprehensive Cancer Infrastructures in every European Union Member State. It is therefore important to establish the basic principles for high-performing cancer networks and a methodology for evaluating their quality and effectiveness. This article describes methods and standards/indicators for network evaluation found in literature, gives a comparative overview of the new OECI European Cancer Network Quality standards, and proposes principles for evaluating the performance of Comprehensive Cancer Networks as a basis for continuous improvement. We performed a scoping literature review on methods and standards/indicators for care-network evaluation. We then compared the OECI set with literature findings, categorised standards that were similar, reflected on standards that were different, and deduced principles for quality standards for cancer networks. Of 1002 articles identified, 17 reported on evaluation methods and/or (mostly) qualitative indicators. Sixteen studies described indicators/standards for evaluating care networks, critical success factors or desirable outcomes. Of the 54 present OECI standards, 32 had a literature equivalent. No literature equivalent was found for 22 standards, especially on those related to the combination of care and research. The proposed OECI evaluation methods (survey, document review, and interviews) were all reported in the literature. From the conformity of these results, we deduced 8 principles for standards evaluating the effectiveness of Comprehensive Cancer Networks. Research on the evaluation of the effectiveness of care networks is scarce. Evaluation methods vary and are often single time-point assessments. The OECI set contributes to establishing clear principles and standards to evaluate the effectiveness of Comprehensive Cancer Networks.

为保障全体公民平等享有高质量癌症诊疗服务，欧盟健康计划（EU4Health Programme）、欧洲抗癌计划（Europe’s Beating Cancer Plan）以及地平线欧洲癌症任务（Horizon Europe’s Cancer Mission）提议在所有欧盟成员国建设综合癌症基础设施（Comprehensive Cancer Infrastructures）。因此，确立高性能癌症网络的基本原则，以及一套评估其质量与成效的方法论，具备重要现实意义。本文首先梳理了现有文献中用于诊疗网络评估的方法、标准与指标，对新版OECI（Organization of European Cancer Institutes）欧洲癌症网络质量标准开展比较性综述，并提出综合癌症网络（Comprehensive Cancer Networks）绩效评估原则，以期为持续改进工作提供依据。我们针对诊疗网络评估的方法、标准与指标开展了范围界定文献综述。随后将OECI制定的标准与文献研究结果进行比对，对相似标准进行归类，对存在差异的标准展开分析，并据此推导得出癌症网络质量标准的核心原则。在检索到的1002篇文献中，17篇涉及评估方法或（多为）定性指标；16篇阐述了用于评估诊疗网络的指标/标准、关键成功因素或预期成果。在OECI现有的54项标准中，32项可在文献中找到对应标准，剩余22项（尤其是涉及诊疗与研究融合的标准）未发现等效文献标准。OECI提议的评估方法（问卷调查、文档审查与访谈）均在现有文献中有所记载。基于上述结果的一致性，我们推导得出8项用于评估综合癌症网络成效的标准原则。当前针对诊疗网络成效评估的研究仍较为匮乏，评估方法多样且多为单时间点评估。OECI标准体系有助于确立明确的原则与标准，以评估综合癌症网络的服务成效。